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Sector responds to 'shocking' £83m pharmacist fraud claims

Howard Duff: Pharmacists will be shocked and appalled by the allegations

Royal Pharmaceutical Society (RPS) director Howard Duff is one of the pharmacy leaders who has slammed pharmacists responsible for allegedly defrauding the NHS of £83m a year

Pharmacy bodies have condemned fraudulent pharmacists who allegedly cost the NHS more than £80 million a year.

NHS figures from between 1998 and 2014 suggest that fraud committed by pharmacists costs the health service at least £83m a year, accountancy firm PKF Littlejohn claimed in a report yesterday (September 24).

This figure, based on the average loss rate in the NHS, includes pharmacists claiming money for services they have not provided and failing to declare prescription charges they collect, PKF Littlejohn said.

Royal Pharmaceutical Society (RPS) director for England Howard Duff said the “vast majority” of pharmacists will be “shocked and appalled” by the report’s allegations, because they “work hard to ensure every penny of NHS funding is used to improve patient care”. 

Pharmacists who defraud the NHS are "indefensible" and the RPS "fully supports" any government action to tackle this issue, he told C+D yesterday (September 24).

Pharmacy Voice chief executive Rob Darracott said he “unconditionally condemns isolated incidents where a community pharmacist has committed fraud”. 

Other fraud

The PFK Littlejohn report also referenced a Daily Mail article from 2014 that said patients fraudulently claiming free prescriptions cost the NHS £237m a year. Mr Darracott stressed that it is a "challenge" for pharmacists to detect this.

"Collecting the fees and policing prescriptions adds to a pharmacists' workload without benefitting patient care. Pharmacy Voice strongly believes that we should overhaul the system, and do away with prescription charges altogether," he added.

In its report, PKF Littlejohn estimated that fraud costs the NHS £3.73 billion a year. This includes at least £121m of fraud by dentists, £12.9m by opticians, and £348m by GPs.

The accountancy firm calculated these figures using data from a series of NHS loss measurement exercises conducted between 1998 and 2014. It called on the NHS to recommence these exercises to generate "accurate knowledge about the extent of fraud".

The Department of Health refused to recognise the “highly speculative report, which is full of inconsistencies”. It is "determined to stamp out fraud in the NHS" and plans to "do even more in the future", it told C+D.

Last year, the DH announced plans for pharmacists to electronically verify patients' eligibility for free prescriptions from 2018 as part of efforts to crack down on prescription fraud.


How can the sector tackle fraud?

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Amal England, Public Relations

I find it hard to understand how Mr Duff and Mr Darracott have accepted this report based on averages of estimates, almost as though they are a novice in the realm of NHS finances. They should be trying to 'rip' this guess work of a report into shreds and championing their profession! I am utterly disgusted. People need to realise that NHS money is first handed over to doctors, by doctors, from this pharmacists are then paid. For this reason doctors are able to cut pharmacy financing from every angle, such as dispensing fee and category M reductions. In effct pharmacy have been defrauded for the last 15 years. Hence we are in a position of providing so much for £0.00, as a previous commentee pointed out! What should really be addressed, as a priority is the fraud committed by doctors and the direct and indirect cost of poor care at the hands of doctors. These two combined are probably costing the tax payer well in excess of a billion pounds. Not to mention all those GP partners earning over £100,000 a year for a mere 3 or 4 days of work per week, paid for by the tax payer.

John Randell, Non Pharmacist Branch Manager

nothing mentions about the billions of pounds in goverment under payment

Dave Downham, Manager

I've just re-read this article again. What a load of rubbish. I reckon about 76.2% of the statistics are made up.

ALKESH DESAI, Dispenser Manager/ Dispensing Assistant

"Loss measurement estimate" a new concept! How and what criteria was applied to derive loss figures to the NHS? Would such a loss measurement exercise work on all government and private enterprises, in which case I would presume that they must have (i.e. PKF Littlejohn) been able to pilot such an exercise with a good level of confidence! Statistical data can only be relied upon if there is a good level of confidence. Picking on the pharmacists has always been easy as they are an easy target but no mention of the famous quote " See your pharmacist" on TV and media. We provide a lot of services absolutely free, repeat collection and delivery of prescriptions, free advice to walk-in customers and over the phone, free provision of Dossett medication in trays, and so on. Hence, my reservation about the inflated estimate of fraud committed by pharmacies. Simple solution to the problem of fraud would be to charge everybody £1.00 per item no exemptions. This will ensure, reduced waste of medications, and all scripts issued whether paper or electronically, returned to PPA for payment hence no fraud. NHS would rake in a lot of revenue and stop wastage of doctor's time which can be useful to deal with more serious issues. Dentists are still not computerised, Why? Doctor's surgeries and pharmacies are, so why is there an exemption for Dentists and opticians? Surely, they form a component of the Primary care system! In any case it would be wise to learn who actually paid for the survey.

Neeraj Salwan, Superintendent Pharmacist

£348million fraud by GPs, that's more then the 3 other professions- dentists, pharmacists & opticians put together. Surely that's where they should be targeting their efforts but everyone knows that the government are shit scared of GPs and here in lies the fault of the system and society on a whole, the powerful get away with murder, enough said...

Brian Austen, Senior Management

This type of report is aimed at distracting the public away from the real problem, which is that the NHS is under-funded if the DoH expect continuation of the current service provision. It would have had more weight if specific examples of fraud by pharmacies was given. The NHS is allowed to publish such information. I suspect there is not enough evidence to support the findings.

Dave Downham, Manager

Are the voting buttons disabled or are the ratings another example of dubious data and conclusions thereon?

Z ZZzzzz, Information Technology

I was going to try and stay out of this discussion. However now I have taken the time to read the actual report rather than the headlines that most media commentators have done it does make for some sobering thought. The comments on this board with regards to the NHS constantly almost gleefully ripping contractors off with their "jobsworth" rules like script switching and not responding quickly enough to shortages creating vastly increased procurement costs until eventually some of them are covered by concessionary pricing which always has to start from scratch each new month, I do strongly sympathise with. But these are not excuses for those contractors allegedly commiting the fraud. The report in its completion does not completely stack up and Mr Gee does like to compare apples with oranges sometimes. I have lots of questions that I would like to ask him (probably best incognito in an unmonitored soundproof room) but here are a couple anyway. Does he have stats that compare the fraud rate between England and those countries in the UK that don't have NHS script charges - is the percentage fraud better or worse, or does it not make any difference. The other is for the DH. Why has there never been a successful NHS loss measurement exercise looking at expenditure on General Practice when there have been 6 for Dental services, 6 for Pharmaceutical services and 9 for Optical services - according to the report. Does the DH possibly think the extent of the fraud in GPland could be even larger than that indicated by Mr Gee and they don't really want to wind patients up even more than they already are about General Practice.

S Morein, Pharmacy Area manager/ Operations Manager

It is probably an underestimate of the fraud committed. How many pharmacists incorrectly endorse? How many fail to clearly indicate when a product is not dispensed? How many re use returned medication? How many use imported medication of a dubious provenance? How many MUR's are of an unsatisfactory nature? How many fees for medicines less the the prescription charge are kept? And there are plenty of other ways to defraud too. These problem are almost always with the small independent contractors where the illegal benefit goes straight to the owner.

John Alan James Robinson, Superintendent Pharmacist

Shame on you. Where is your evidence. what about some of the GPHC cases on MUR's ? I seem to recall that multiples were involved especially with whistleblowing. Rather than cast aspersions let us know who these people are. The practices you mention are easily uncovered. There will always be some in any profession who cheat. That does not mean that the whole sector is at it. Do I detect a degree of cynicism born of envy ?

Just because there are ways to defraud doesn't mean it is widespread. In my experience, many of the little guys in community are providing services above and beyond that which is remunerated

Super Pharmacist, Community pharmacist

What about contractors being defrauded themselves through countless ppd mistakes, not being paid broken bulk on dressing or items costing less than £50, etc etc. Not condoning the very few unscrupulous characters out there but it should be viewed from both perspectives!!

A load of desperate job seeking by Gee and Littlejohnand their random number generators. Clearly if you are going to tell a lie tell a whopper. A risibly appalling piece of work. Just imagine if it was true eh? That would reflect terribly on NHS Counter Fraud wouldn't it. Surely they'd have to look at the recent leadership which would be.....Gee himself! With Gees arbitrary grasp of money and numbers perhaps his current employers should have a look at his own qualifications, pay and expense claims before they castigate NHS staff.

Ashley Cohen, Community pharmacist

I would also be interested in knowing how many pharmacies are losing out on genuine revenue because they were being harshly treated by the NHS or other NHS bodies. Exempt to chargeable switches seems to spring to mind! Its a draconian the system to simply remove monies from pharmacies because of tick box even though the NHS know the patients is exempt and we did not collect a fee for an item.

London Locum, Locum pharmacist

If only. The fraudsters they should be looking for happen to be the biggest chain on the high street. Their taxes could also do with a forensic investigation. But I doubt the government or any of the pharmacy bodies will lift a finger. Far easier to prosecute individual pharmacists for eating a choc bar and plastering them all over the C&D for 'theft'. The old addage remains true - Steal $100 and you've got a problem but steal $1,000,000 and it's their problem.

Dave Downham, Manager

Clearly, it's the Daily Mail so it must be true. my maths that's about £6,000 per pharmacy based on 14,000 pharmacies. Let's assume that 90% of pharmacists aren't crooks. So that's 1 in 10 pharmacies trousering an average £60k per year through fraud. That suggests there will be a few who are robbing the tax payer of well over £100k a year. Sorry, I don't buy those numbers at all.

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